This invention relates to squalene synthetase inhibitors, pharmaceutical compositions containing such inhibitors and the use of such inhibitors to treat hypercholesterolemia, hypertriglyceridemia, atherosclerosis, fungal infections, acne and Alzheimer""s disease in mammals, including humans.
Plasma cholesterol levels have been positively correlated with the incidence of clinical events associated with coronary heart disease (CHD). Thus, pharmacological interventions that reduce cholesterol levels in mammals have a beneficial effect on CHD. In particular, decreased plasma low density lipoprotein (LDL) cholesterol levels are associated with decreased atherosclerosis and a decreased risk of CHD, and hypolipidemic agents used in either monotherapy or combination therapy are effective at reducing plasma LDL cholesterol levels and the subsequent risk of CHD.
Cholesterol metabolism in mammals involves a series of pathways including cholesterol absorption in the small intestine, cholesterol biosynthesis in numerous tissues (primarily the liver and small intestine), bile acid biosynthesis in the liver and reabsorption in the small intestine, synthesis of cholesterol-containing plasma lipoproteins by the liver and intestine, catabolism of the cholesterol-containing plasma lipoproteins by the liver and extrahepatic tissues and secretion of cholesterol and bile acids by the liver.
Cholesterol synthesis occurs in multiple tissues, but principally in the liver and the intestine. It is a multistep process starting from acetyl-coenzyme A catalyzed by a series of enzymes including hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase, HMG-CoA synthase, squalene synthetase, squalene epoxidase, squalene cyclase and lanosterol demethylase. Inhibition of catalysis by these enzymes or blocking HMG-CoA reductase gene expression is recognized as an effective means to reduce cholesterol biosynthesis (thus inhibitors thereof are referred to as cholesterol synthesis inhibitors) and can lead to a reduction in cholesterol levels. For example, there are known HMG-CoA reductase inhibitors (e.g., lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, rivastatin) that are used for the treatment of hypercholesterolemia.
Recently adopted National Cholesterol Education Program guidelines recommend aggressive lipid-lowering therapy for patients with pre-existing cardiovascular disease or for those with multiple factors that place them at increased risk.
The term squalene synthetase inhibitor refers to compounds that inhibit the condensation of 2 molecules of famesylpyrophosphate to form squalene, a reaction that is catalyzed by the enzyme squalene synthetase. Such inhibition is readily determined by those skilled in the art according to standard assays (Meth. Enzymol. 1969; 15: 393-454 and Meth. Enzymol. 1985; 110:359-373 and references contained therein). A summary of squalene synthetase inhibitors has been compiled (Curr. Op. Ther. Patents (1993) 8614). European patent publication 0 567 026 A1 discloses certain 4,1-benzoxazepine derivatives as squalene synthase inhibitors and their use in the treatment of hypercholesterolemia and as fungicides. European patent publication 0 645 378 A1 discloses certain condensed seven- or eight-membered heterocycles as squalene synthetase inhibitors and their use in treatment and prevention of hypercholesterolemia and fungal infections. European patent publication 0 645 377 A1 discloses certain benzoxazepine derivatives as squalene synthetase inhibitors useful for the treatment of hypercholesterolemia or coronary sclerosis. European patent publication 0 611 749 A1 discloses certain substituted amic acid derivatives useful for treatment of arteriosclerosis. European patent publication 0705607 A2 discloses certain condensed seven- or eight-membered heterocyclic compounds useful as antihypertriglyceridemic agents. PCT Publication WO 96/09827 discloses certain combinations of cholesterol absorption inhibitors and cholesterol synthesis inhibitors including benzoxazepin derivatives and benzothiazepinone derivatives. European patent publication 0710725 A1 discloses a process for producing certain optically active compounds, including benzoxazepine compounds, having plasma cholesterol and triglyceride lowering activities.
Thus, although there are a variety of hypercholesterolemia therapies, there is a continuing need and a continuing search in this field of art for alternative therapies.
This invention is directed to cholesterol synthesis inhibitor compounds of FORMULA I useful for the treatment of hypercholesterolemia, hypertriglyceridemia, atherosclerosis, fungal infections, Alzheimer""s disease and acne.
The compounds of this invention have the Formula I 
or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof wherein
X is oxy, thio, xe2x80x94S(O)xe2x80x94 or xe2x80x94S(O)2xe2x80x94;
Y is carbonyl or methylene;
R1 and R2 are each independently hydrogen, halo, hydroxyl, trifluoromethyl, (C1-C4)alkyl, fluorinated (C1-C4)alkyl having from 1 to 9 fluorines, (C1-C4)alkoxy, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkylthio, (C1-C4)alkylsulfinyl, (C1-C4)alkylsulfonyl, phenyl, amino, mono-N- or di-N,N-(C1-C4)alkylamino, carboxyl, (C1-C4)alkoxycarbonyl, carbamoyl, mono-N- or di-N,N-(C1-C4)alkylcarbamoyl, (C1-C4)alkanoylamino, fluorinated (C1-C4)alkanoylamino having from 1 to 9 fluorines, (C1-C4)alkylsulfonylamino or fluorinated (C1-C4)alkylsulfonylamino having from 1 to 9 fluorines, (C1-C4)alkanoyl, (C1-C6)alkanoyl(C1-C6)alkyl, oxazolyl, thiazolyl, isoxazolyl, pyrazolyl or isothiazolyl wherein said preceding heterocycles are carbon linked or wherein R1 and R2 can be taken together to form a five, six or seven membered carbocyclic ring or can be taken together to form methylenedioxyl, ethylenedioxyl or propylenedioxyl and such rings formed by taking R1 and R2 together are fused at the 7 and 8 positions;
R3, R9 and R10 are each independently hydrogen, halo, hydroxyl, trifluoromethyl, (C1-C4)alkyl, fluorinated (C1-C4)alkyl having from 1 to 9 fluorines, (C1-C4)alkoxy, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkylthio, (C1-C4)alkylsulfinyl, (C1-C4)alkylsulfonyl, phenyl, amino, mono-N- or di-N,N-(C1-C4)alkylamino, carboxyl, (C1-C4)alkoxycarbonyl, carbamoyl, mono-N- or di-N,N-(C1-C4)alkylcarbamoyl, (C1-C4)alkanoylamino, fluorinated (C1-C4)alkanoylamino having from 1 to 9 fluorines, (C1-C4)alkylsulfonylamino or fluorinated (C1-C4)alkylsulfonylamino having from 1 to 9 fluorines, (C1-C6)alkanoyl, (C1-C6)alkanoyl(C1-C6)alkyl, oxazolyl, thiazolyl, isoxazolyl, pyrazolyl or isothiazolyl wherein said preceding heterocycles are carbon linked or wherein R3 and R9 can be taken together to form a five, six or seven membered carbocyclic ring or can be taken together to form methylenedioxyl, ethylenedioxyl or propylenedioxyl and such rings formed by taking R3 and R9 together are fused at the 2xe2x80x2 and 3xe2x80x2 or 3xe2x80x2 and 4xe2x80x2 positions;
R4 is (C1-C?)alkyl, (C1-C7)alkenyl or (C3-C4)cycloalkylmethyl or said (C1-C7)alkyl, (C1-C7)alkenyl or (C3-C4)cycloalkylmethyl is optionally mono-, di-, or tri-substituted wherein the substituents are independently chosen from hydroxyl, oxo, (C1-C4)alkyl, amino, carboxy, thiol, (C1-C4)alkoxy, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkylthio, (C1-C4)alkylsulfinyl, (C1-C4)alkylsulfonyl, mono-N- or di-N,N-(C1-C4)alkylamino, mono-N- or di-N,N-(C1-C4)alkylaminocarbonyl, mono-N-or di-N,N(C1-C4)alkylaminosulfonyl; or
R4 is (C1-C7)alkyl substituted with 1 to 15 fluorines or (C3-C4)cycloalkylmethyl substituted with 1 to 9 fluorines; or
R4 is het(C1-C6)alkyl wherein het is a 4-7 member saturated or unsaturated heterocycle containing independently one to three O, N or S atoms and said het is optionally mono-substituted with (C1-C4)alkyl, (C1-C4)alkoxy, hydroxyl, halo, amino or mono-N- or di-N,N-(C1-C4)alkylamino;
Z is carboxyl, (C1-C4)alkoxycarbonyl, mono-N- or di-N,N-(C1-C4)alkylaminocarbonyl, aminocarbonyl, cyano, hydroxyaminocarbonyl, xe2x80x94C(O)N(H)SO2R5, tetrazol-5-yl, 4,5-dihydro-5-oxo-1,2,4-oxadiazol-3-yl, tetrazol-5-yl-aminocarbonyl, 3-oxoisoxazolidin-4-yl-aminocarbonyl, N(R12)CONR13R14, N(R12)CO2 (C1-C4)alkyl or N(R12)COR15;
Z1 is H, carboxyl, hydroxyl, (C1-C4)alkoxy or (C1-C4)alkoxycarbonyl;
R12, R13 and R14 are each independently H or (C1-C4)alkyl;
R15 is (C1-C4)alkyl;
R5 is amino or mono-N- or di-N,N-(C1-C4)alkylamino; or R5 is (C1-C4)alkyl optionally substituted with 1 to 9 fluorines, amino, mono-N- or di-N,N-(C1-C4)alkylamino, carboxyl, (C1-C4)alkoxycarbonyl, carbamoyl or mono-N- or di-N,N-(C1-C4)alkylcarbamoyl; or R5 is phenyl optionally mono- or di-substituted independently with methyl, methoxyl, fluoro, trifluoromethoxyl, carboxyl, (C1-C4)alkoxycarbonyl, methylthio, methylsulfinyl, methylsulfonyl, (C1-C4)alkylsulfonylamino or mono-N- or di-N,N-(C1-C4)alkylaminosulfonyl; or
R5 is thiazolyl, isothiazolyl, thienyl, furyl, pyridinyl or any of said heterocycles optionally mono-substituted by carboxyl, or mono- or di-substituted with methyl; and
T forms a four to seven membered mono-aza, saturated ring, said ring optionally containing thio or oxo and said ring optionally mono-substituted on carbon with hydroxyl, (C1-C4)alkoxy or carboxyl.
A preferred group of compounds, designated the xe2x80x9cA Groupxe2x80x9d, contains those compounds having the Formula I as shown above wherein the C3 and C5 substituents are trans;
R1 and R2 are each independently hydrogen, halo, (C1-C4)alkyl, (C1-C4)alkoxy, hydroxy, trifluoromethyl, (C1-C4)alkylthio, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkanoyl or R1 and R2 taken together form an ethylenedioxy ring;
R3, R9 and R10 are each independently hydrogen, halo, (C1-C4)alkyl, (C1-C4)alkoxy, hydroxy, trifluoromethyl, (C1-C4)alkylthio, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkanoyl or R3 and R9 taken together form an (C1-C3)alkylenedioxy ring;
X is oxy;
Y is carbonyl;
Z is carboxyl or tetrazol-5-yl; and
Z1 is H or carboxyl.
A group of compounds, which is preferred among the xe2x80x9cA Groupxe2x80x9d of compounds designated the xe2x80x9cB Groupxe2x80x9d, contains those compounds wherein Zi is H;
T forms a piperidin-1-yl ring; and
R3 and R9 are each independently (C1-C4)alkoxy or taken together form a (C1-C3)alkylenedioxy ring.
A group of compounds, which is preferred among the xe2x80x9cB Groupxe2x80x9d of compounds designated the xe2x80x9cC Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cB Groupxe2x80x9d of compounds designated the xe2x80x9cD Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cB Groupxe2x80x9d of compounds designated the xe2x80x9cE Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cB Groupxe2x80x9d of compounds designated the xe2x80x9cF Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the a xe2x80x9cB Groupxe2x80x9d of compounds designated the xe2x80x9cG Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 and R9 are taken together to form 2xe2x80x2, 3xe2x80x2-ethylenedioxyl; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cB Groupxe2x80x9d of compounds designated the xe2x80x9cH Groupxe2x80x9d, contains those compounds wherein R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 and R9 are taken together to form 2xe2x80x2, 3xe2x80x2-ethylenedioxyl; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cA Groupxe2x80x9d of compounds designated the xe2x80x9cI Groupxe2x80x9d, contains those compounds wherein
T forms a pyrrolidin-1-yl ring;
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy;
Z is 2-carboxyl; and
Z1 is H.
A group of compounds, which is preferred among the xe2x80x9cA Groupxe2x80x9d of compounds designated the xe2x80x9cJ Groupxe2x80x9d, contains those compounds wherein
T forms a pyrrolidin-1-yl ring;
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 and R9 are taken together to form 2xe2x80x2, 3xe2x80x2-ethylenedioxyl;
Z is 2-carboxyl; and
Z1 is H.
A group of compounds, which is preferred among the xe2x80x9cA Groupxe2x80x9d of compounds designated the xe2x80x9cK Groupxe2x80x9d, contains those compounds wherein
T forms a piperidin-1-yl ring;
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R1 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy;
Z is 4-carboxyl; and
Z1 is 2-carboxyl.
A preferred group of compounds, designated the xe2x80x9cL Groupxe2x80x9d, contains those compounds having the Formula I as shown above wherein the C3 and C5 substituents are trans;
R1 and R2 are each independently hydrogen, halo, (C1-C4)alkyl, (C1-C4)alkoxy, hydroxy, trifluoromethyl, (C1-C4)alkylthio, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkanoyl or R1 and R2 taken together form an ethylenedioxy ring;
R3, R9 and R10 are each independently hydrogen, halo, (C1-C4)alkyl, (C1-C4)alkoxy, hydroxy, trifluoromethyl, (C1-C4)alkylthio, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkanoyl or R3 and R9 taken together form an (C1-C3)alkylenedioxy ring;
X is oxy;
Y is methylene;
Z is carboxyl or tetrazol-5yl; and
Z1 is H.
A group of compounds, which is preferred among the xe2x80x9cL Groupxe2x80x9d of compounds designated the xe2x80x9cM Groupxe2x80x9d, contains those compounds wherein
T forms a piperidin-1-yl ring; and
R3 and R9 are each independently (C1-C4)alkoxy or taken together form a (C1-C3)alkylenedioxy ring.
A group of compounds, which is preferred among the xe2x80x9cM Groupxe2x80x9d of compounds designated the xe2x80x9cN Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 and R9 are taken together to form 2xe2x80x2, 3xe2x80x2-ethylenedioxyl; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cM Groupxe2x80x9d of compounds designated the xe2x80x9cO Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 and R9 are taken together to form 2xe2x80x2, 3xe2x80x2-ethylenedioxyl; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cM Groupxe2x80x9d of compounds designated the xe2x80x9cP Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 4-carboxyl.
A preferred group of compounds, designated the xe2x80x9cQ Groupxe2x80x9d, contains those compounds having the Formula I as shown above wherein
the C3 and C5 substituents are trans;
R1 and R2 are each independently hydrogen, halo, (C1-C4)alkyl, (C1-C4)alkoxy, hydroxy, trifluoromethyl, (C1-C4)alkylthio, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkanoyl or R1 and R2 taken together form an ethylenedioxy ring;
R3, R9 and R10 are each independently hydrogen, halo, (C1-C4)alkyl, (C1-C4)alkoxy, hydroxy, trifluoromethyl, (C1-C4)alkylthio, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkanoyl or R3 and R9 taken together form an (C1-C3)alkylenedioxy ring;
X is thio;
Y is carbonyl;
Z is carboxyl or tetrazol-5-yl; and
Z1 is H.
A group of compounds, which is preferred among the a xe2x80x9cQ Groupxe2x80x9d of compounds designated the a xe2x80x9cR Groupxe2x80x9d, contains those compounds wherein
T forms a piperidin-1-yl ring; and
R3 and R9 are each independently (C1-C4)alkoxy or taken together form a (C1-C3)alkylenedioxy ring.
A group of compounds, which is preferred among the xe2x80x9cR Groupxe2x80x9d of compounds designated the xe2x80x9cS Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the a xe2x80x9cR Groupxe2x80x9d of compounds designated the xe2x80x9cT Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methylthio;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cR Groupxe2x80x9d of compounds designated the xe2x80x9cU Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methylthio;
R2 is H;
R10 is H;
R3 is 2xe2x80x2-methoxy;
R9 is 3xe2x80x2-methoxy; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cR Groupxe2x80x9d of compounds designated the xe2x80x9cV Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 and R9 are taken together to form 2xe2x80x2, 3xe2x80x2-ethylenedioxyl; and
Z is 3-carboxyl.
A preferred group of compounds, designated the xe2x80x9cW Groupxe2x80x9d, contains those compounds having the Formula I as shown above wherein the compounds are
(xe2x88x92)-N-[trans-7-chloro-5-(2,3-ethylenedioxyphenyl)-neopentyl-1,2,3,5-tetrahydro-2-oxo-4,1-benzoxazepine-3-acetyl]isonipecotic acid;
(xe2x88x92)-N-[Trans-7-chloro-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
(xe2x88x92)-N-[Trans-7-chloro-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid;
(xe2x88x92)N-[Trans-7-chloro-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]-L-proline;
(xe2x88x92)-N-[Trans-7-methyl-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
(xe2x88x92)-N-[Trans-7-methyl-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid; and
(xe2x88x92)-N-[Trans-7-chloro-5-(2,3-ethylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid.
The above seven compounds are also especially preferred as individual compounds.
A group of compounds, which is preferred among the xe2x80x9cA Groupxe2x80x9d of compounds designated the xe2x80x9cX Groupxe2x80x9d, contains those compounds wherein
Z1 is H;
T forms a piperidin-1-yl ring; and
R3 and R9 are each independently H, (C1-C4)alkoxy, trifluoromethoxy, or taken together form a (C1-C3)alkylenedioxy ring.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cY Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2-methoxy;
R9 is 4methoxy; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cZ Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-ethylenedioxy ring; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cA1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-ethylenedioxy ring; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cB1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2-methoxy;
R9 is H; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cC1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2-trifluoromethoxy;
R9 is H; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cB1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 is 2-methoxy; and
R9 is H; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cE1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2is H;
R10 is H;
R3 and R9 are taken together form a 2,3-methylenedioxy ring; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cF1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-chloro;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-methylenedioxy ring; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cG1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-methylenedioxy ring; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cH1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methyl;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-methylenedioxy ring; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cI1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-methoxy;
R2is H;
R10 is H;
R3 is 2-methoxy;
R9 is 3-methoxy; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cJ1 Groupxe2x80x9d, contains those compounds wherein
R4is neopentyl;
R1 is 7-trifluoromethoxy;
R2 is H;
R10 is H;
R3 is 2-methoxy;
R9 is 3-methoxy; and
Z is carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cK1 Groupxe2x80x9d, contains those compounds wherein
R4is neopentyl;
R1 is 7-trifluoromethoxy;
R2 is H;
R10 is H;
R3 is 2-methoxy;
R9 is 3-methoxy; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cL1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-trifluoromethoxy;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-ethylenedioxy ring; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cM1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-trifluoromethoxy;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-ethylenedioxy ring; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cN1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-trifluoromethoxy;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-methylenedioxy ring; and
Z is 4-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cO1 Groupxe2x80x9d, contains those compounds wherein
R4 is neopentyl;
R1 is 7-trifluoromethoxy;
R2 is H;
R10 is H;
R3 and R9 are taken together form a 2,3-methylenedioxy ring; and
Z is 3-carboxyl.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cP1 Groupxe2x80x9d, are the following compounds. These compounds are also especially preferred as individual compounds.
a. (xe2x88x92)-N-[Trans-7-chloro-5-(2,4-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
b. (xe2x88x92)-N-[Trans-7-methyl-5-(2,3-ethylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
c. (xe2x88x92)-N-[Trans-7-methyl-5-(2,3-ethylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid;
d. (xe2x88x92)-N-[Trans-7-chloro-5-(2-methoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotc acid; and
e. (xe2x88x92)-N-[Trans-7-chloro-5-(2-trifluoromethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cQ1 Groupxe2x80x9d, are the following compounds. These compounds are also especially preferred as individual compounds.
a. (xe2x88x92)-N-[Trans-7-chloro-5-(2-methoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid;
b. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-methylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
c. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-methylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid;
d. (xe2x88x92)-N-[Trans-7-methyl-5-(2,3-methylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid; and
e. (xe2x88x92)-N-[Trans-7-methyl-5-(2,3-methylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cR1 Groupxe2x80x9d, are the following compounds. These compounds are also especially preferred as individual compounds.
a. (xe2x88x92)-N-[Trans-7-methoxy-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid;
b. (xe2x88x92)-N-[Trans-7-trifluoromethoxy-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid;
c. (xe2x88x92)-N-[Trans-7-trifluoromethoxy-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
d. (-N-[Trans-7-trifluoromethoxy-5-(2,3-ethylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid; and
e. (xe2x88x92)-N-[Trans-7-trifluoromethoxy-5-(2,3-ethylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid.
A group of compounds, which is preferred among the xe2x80x9cX Groupxe2x80x9d of compounds designated the xe2x80x9cS1 Groupxe2x80x9d, are the following compounds. These compounds are also especially preferred as individual compounds.
a. (xe2x88x92)-N-[Trans-7-trifluoromethoxy-5-(2,3-methylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid; and
b. (-N-[Trans-7-trifluoromethoxy-5-(2,3-methylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid.
A preferred group of compounds, designated the xe2x80x9cS2 Groupxe2x80x9d, contains the following compounds. These compounds are also especially preferred as individual compounds.
a. (-N-[Trans-7-chloro-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
b. (xe2x88x92)-N-[Trans-7-methyl-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
c. (-N-[Trans-7-methyl-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid;
d. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid; and
e. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-ethylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]nipecotic acid.
A preferred group of compounds, designated the xe2x80x9cS3 Groupxe2x80x9d, contains the following compounds. These compounds are also especially preferred as individual compounds.
a. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-ethylenedioxyphenyl-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]isonipecotic acid;
b. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]-L-proline;
c. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-ethylenedioxyphenyl)-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]-L-proline;
d. (xe2x88x92)-N-[Trans-7-chloro-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzoxazepin-3-acetyl]-cis-2,4-piperidinedicarboxylic acid; and
e. (-N-[Trans-7-methyl-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzothiazepin-3-acetyl]nipecotic acid.
A preferred group of compounds, designated the xe2x80x9cS4 Groupxe2x80x9d, contains the following compounds. These compounds are also especially preferred as individual compounds.
a. (-N-[Trans-7-methylthio-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzothiazepin-3-acetyl]isonipecotic acid;
b. (xe2x88x92)-N-[Trans-7-methylthio-5-(2,3-dimethoxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzothiazepin-3-acetyl]nipecotic acid; and
c. (xe2x88x92)-N-[Trans-7-methyl-5-(2,3-ethylenedioxyphenyl)-1-neopentyl-2-oxo-1,2,3,5-tetrahydro-4,1-benzothiazepin-3-acetyl]nipecotic acid.
Alternatively, for Formula I as shown, above R4 can be (C1-C7)alkyl, (C1-C7)alkenyl or (C3-C4)cycloalkylmethyl or said (C1-C7)alkyl, (C1-C7)alkenyl or (C3-C4)cycloalkylmethyl is optionally mono-, di-, or tri-substituted wherein the substituents are independently chosen from hydroxyl, oxo, (C1-C4)alkyl, amino, carboxy, thiol, (C1-C4)alkoxy, (C1-C4)alkoxycarbonyl, fluorinated (C1-C4)alkoxy having from 1 to 9 fluorines, (C1-C4)alkylthio, (C1-C4)alkylsulfinyl, (C1-C4)alkylsulfonyl, mono-N- or di-N,N-(C1-C4)alkylamino, mono-N- or di-N,N-(C1-C4)alkylaminocarbonyl, mono-N-or di-N,N(C1-C4)alkylaminosulfonyl;
Yet another aspect of this invention is directed to methods for treating hypercholesterolemia, hypertriglyceridemia, atherosclerosis, fungal infections, Alzheimer""s disease and acne in a mammal (including a human being) by administering to a mammal suffering from hypercholesterolemia, hypertriglyceridemia, atherosclerosis, a fungal infection, Akzheimer""s disease or acne a hypercholesterolemia, hypertriglyceridemia, atherosclerosis, anti-fungal, Alzheimer""s disease or acne treating amount of a Formula I compound or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof.
Yet another aspect of this invention is directed to a method for treating hypercholesterolemia in a mammal (including a human being) by administering to a mammal suffering from hypercholesterolemia a hypercholesterolemia treating amount of a Formula I compound or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof.
Yet another aspect of this invention is directed to a method for treating hypertriglyceridemia in a mammal (including a human being) by administering to a mammal suffering from hypertriglyceridemia a hypertriglyceridemia treating amount of a Formula I compound or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof.
Yet another aspect of this invention is directed to a method for treating atherosclerosis in a mammal (including a human being) by administering to a mammal suffering from atherosclerosis an atherosclerotic treating amount of a Formula I compound or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof.
Yet another aspect of this invention is directed to a method for treating a fungal infection in a mammal (including a human being) by administering to a mammal suffering from a fungal infection an antifungal treating amount of a Formula I compound or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof.
Yet another aspect of this invention is directed to a method for treating Alzheimer""s disease in a mammal (including a human being) by administering to a mammal suffering from Alzheimer""s disease an Alzheimer""s disease treating amount of a Formula I compound or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof.
Yet another aspect of this invention is directed to a method for treating acne in a mammal (including a human being) by administering to a mammal suffering from acne an acne treating amount of a Formula I compound or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof.
This invention is also directed to pharmaceutical compositions which comprise a therapeutically effective amount of a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
This invention is also directed to pharmaceutical compositions for the treatment of hypercholesterolemia, hypertriglyceridemia, atherosclerosis, fungal infections, Alzheimer""s or acne in a mammal (including a human being) which comprise a therapeutically effective amount of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
This invention is also directed to pharmaceutical compositions for the treatment of hypercholesterolemia in a mammal (including a human being) which comprise a hypercholesterolemia treating amount of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
This invention is also directed to pharmaceutical compositions for the treatment of hypertriglyceridemia in a mammal (including a human being) which comprise a hypertriglyceridemia treating amount of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
This invention is also directed to pharmaceutical compositions for the treatment of atherosclerosis in a mammal (including a human being) which comprise an atherosclerosis treating amount of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
This invention is also directed to pharmaceutical compositions for the treatment of a fungal infection in a mammal (including a human being) which comprise an antifungal treating amount of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
This invention is also directed to pharmaceutical compositions for the treatment of Alzheimer""s disease in a mammal (including a human being) which comprise an Alzheimer""s disease treating amount of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
This invention is also directed to pharmaceutical compositions for the treatment of acne in a mammal (including a human being) which comprise an acne treating amount of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier.
Another aspect of this invention is a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof or a composition which comprises an amount thereof, for use as a medicament, in particular as an antifungal agent, hypocholesterolemic agent, hypotriglyceridemic agent, anti-atherosclerosis agent, anti-Alzheimer""s disease agent or anti-acne agent.
Yet another aspect of this invention is the use of a compound of the Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof or a composition which comprises an amount thereof, for the manufacture of an antifungal agent, hypocholesterolemic agent, hypoglyceridemic agent, anti-atherosclerosis agent, anti-Alzheimer""s disease agent or anti-acne agent.
This invention is also directed to a pharmaceutical combination composition for the treatment of hypercholesterolemia comprising:
a therapeutically effective amount of a first compound, said first compound being a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof;
a therapeutically effective amount of a second compound, said second compound being a cholesterol absorption inhibitor, a cholesterol synthesis inhibitor (other than the compounds of Formula I), a fibrate, niacin, an ion-exchange resin, an antioxidant, an ACAT inhibitor or a bile acid sequestrant; and
a pharmaceutical carrier.
Preferred among the second compounds are an HMG-CoA reductase inhibitor, an HMG-CoA synthase inhibitor, an inhibitor of HMG-CoA reductase gene expression, a squalene epoxidase inhibitor, a squalene cyclase inhibitor, a lanosterol demethylase inhibitor, a fibrate, niacin, an ion-exchange resin, an antioxidant, an ACAT inhibitor or a bile acid sequestrant.
A particularly preferred HMG-CoA reductase inhibitor is lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin or rivastatin.
A particularly preferred lanosterol demethylase inhibitor is fluconazole or voriconazole.
Another aspect of this invention is a method for treating hypercholesterolemia in a mammal comprising administering to a mammal suffering from hypercholesterolemia
a therapeutically effective amount of a first compound, said first compound being a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof; and
a therapeutically effective amount of a second compound, said second compound being a cholesterol absorption inhibitor or a cholesterol synthesis inhibitor (other than the compounds of Formula I), a fibrate, niacin, an ion-exchange resin, an antioxidant, an ACAT inhibitor or a bile acid sequestrant.
A preferred aspect of the above method is wherein the second compound is an HMG-CoA reductase inhibitor, an HMG-CoA synthase inhibitor, an inhibitor of HMG-CoA reductase gene expression, a squalene epoxidase inhibitor, a squalene cyclase inhibitor, a lanosterol demethylase inhibitor, a fibrate, niacin, an ion-exchange resin, an antioxidant, an ACAT inhibitor or a bile acid sequestrant.
A particularly preferred aspect of the above method is wherein the HMG-CoA reductase inhibitor is lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin or rivastatin.
Yet another aspect of this invention is a kit containing a treatment for hypercholesterolemia comprising:
a. a therapeutically effective amount of a first compound, said first compound being a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier in a first unit dosage form;
b. a therapeutically effective amount of a second compound, said second compound being a cholesterol absorption inhibitor, a cholesterol synthesis inhibitor (other than the compounds of Formula I), a fibrate, niacin, an ion-exchange resin, an antioxidant, an ACAT inhibitor or a bile acid sequestrant and a pharmaceutically acceptable carrier in a second unit dosage form; and
c. container means for containing said first and second dosage forms.
A preferred second compound is an HMG-CoA reductase inhibitor, an HMG-CoA synthase inhibitor, an inhibitor of HMG-CoA reductase gene expression, a squalene epoxidase inhibitor, a squalene cyclase inhibitor, a lanosterol demethylase inhibitor, a fibrate, niacin, an ion-exchange resin, an antioxidant, an ACAT inhibitor or a bile acid sequestrant.
A particularly preferred HMG-CoA reductase inhibitor is lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin or rivastatin.
This invention is also directed to a pharmaceutical combination composition for the treatment of a fungal infection comprising:
a therapeutically effective amount of a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof;
a therapeutically effective amount of a lanosterol demethylase inhibitor; and
a pharmaceutical carrier.
A particularly preferred lanosterol demethylase inhibitor is fluconazole.
Another particularly preferred lanosterol demethylase inhibitor is voriconazole.
Another aspect of this invention is a method for treating a fungal infection in a mammal comprising administering to a mammal suffering from a fungal infection
a therapeutically effective amount of a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof; and
a therapeutically effective amount of a lanosterol demethylase inhibitor.
A particularly preferred aspect of the above method is wherein the lanosterol demethylase inhibitor is fluconazole.
Another particularly preferred aspect of the above method is wherein the lanosterol demethylase inhibitor is voriconazole.
Yet another aspect of this invention is a kit containing a treatment for a fungal infection comprising:
a. a therapeutically effective amount of a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier in a first unit dosage form;
b. a therapeutically effective amount of a lanosterol demethylase inhibitor and a pharmaceutically acceptable carrier in a second unit dosage form; and
c. container means for containing said first and second dosage forms.
A particularly preferred aspect of the above kit is wherein the lanosterol demethylase inhibitor is fluconazole.
Another particularly preferred aspect of the above kit is wherein the lanosterol demethylase inhibitor is voriconazole.
This invention is also directed to a pharmaceutical combination composition for the treatment of acne comprising:
a therapeutically effective amount of a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof;
a therapeutically effective amount of an antibiotic agent; and
a pharmaceutical carrier.
Another aspect of this invention is a method for treating acne in a mammal comprising administering to a mammal suffering from acne
a therapeutically effective amount of a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof; and
a therapeutically effective amount of an antibiotic agent.
Yet another aspect of this invention is a kit containing a treatment for acne comprising:
a. a therapeutically effective amount of a compound of Formula I or the pharmaceutically acceptable cationic and anionic salts, prodrugs or stereoisomers thereof and a pharmaceutically acceptable carrier in a first unit dosage form;
b. a therapeutically effective amount of an antibiotic agent and a pharmaceutically acceptable carrier in a second unit dosage form; and
c. container means for containing said first and second dosage forms.
The term xe2x80x9ctreatingxe2x80x9d, xe2x80x9ctreatxe2x80x9d or xe2x80x9ctreatmentxe2x80x9d as used herein includes preventative (e.g., prophylactic) and palliative treatment.
Exemplary T rings are piperidin-1-yl, pyrrolidin-1-yl, thiazolidin-3-yl, azetidin-1-yl, tetrahydro-1,4-thiazin-4-yl, tetrahydro-1,4-oxazin-4-yl and tetrahydro-1,3-thiazin-3yl.
Exemplary het rings are pyrazolyl, imidazolyl, triazolyl, tetrazolyl, piperidinyl, piperazinyl or morpholino.
By halo is meant chloro, bromo, iodo, or fluoro.
By alkyl is meant straight chain or branched saturated hydrocarbon.
The expression xe2x80x9cpharmaceutically-acceptable anionic saltxe2x80x9d refers to nontoxic anionic salts containing anions such as (but not limited to) chloride, bromide, iodide, sulfate, bisulfate, phosphate, acetate, maleate, fumarate, oxalate, lactate, tartrate, citrate, gluconate and 4-toluene-sulfonate.
The expression xe2x80x9cpharmaceutically-acceptable cationic saltxe2x80x9d refers to nontoxic cationic salts such as (but not limited to) sodium, potassium, calcium, magnesium, ammonium or protonated benzathine (N,Nxe2x80x2-dibenzylethylenediamine), choline, ethanolamine, diethanolamine, ethylenediamine, L-lysine, L-arginine, meglamine (N-methyl-glucamine), benethamine (N-benzylphenethylamine), piperazine or tromethamine (2-amino-2-hydroxymethyl-1,3-propanediol). This is meant to include (R)-xcex1-methylbenzylammonium.
The expression xe2x80x9cprodrugxe2x80x9d refers to compounds that are drug precursors, which following administration, release the drug in vivo via some chemical or physiological process (e.g., a prodrug on being brought to the physiological pH is converted to the desired drug form). Exemplary prodrugs upon cleavage release the corresponding free acid, and such hydrolyzable ester-forming residues of the Formula I compounds include but are not limited to substituents wherein the Z or Z1 moiety is independently carboxyl and the free hydrogen is replaced by (C1-C4)alkyl, (C2-C7)alkanoyloxymethyl, 1-(alkanoyloxy)ethyl having from 4 to 9 carbon atoms, 1-methyl-1-(alkanoyloxy)-ethyl having from 5 to 10 carbon atoms, alkoxycarbonyloxymethyl having from 3 to 6 carbon atoms, 1-(alkoxycarbonyloxy)ethyl having from 4 to 7 carbon atoms, 1-methyl-1-(alkoxycarbonyloxy)ethyl having from 5 to 8 carbon atoms, N-(alkoxycarbonyl)aminomethyl having from 3 to 9 carbon atoms, 1-(N-(alkoxycarbonyl)amino)ethyl having from 4 to 10 carbon atoms, 3-phthalidyl, 4-crotonolactonyl, gamma-butyrolacton-4-yl, di-N,N-(C1-C2)alkylamino(C2-C3)alkyl (such as xcex2-dimethylaminoethyl), carbamoyl-(C1-C2)alkyl, N,N-di(C1-C2)alkylcarbamoyl-(C1-C2)alkyl and piperidino-, pyrrolidino- or morpholino(C2-C3)alkyl.
As used herein, the expression xe2x80x9creaction-inert solventxe2x80x9d and xe2x80x9cinert solventxe2x80x9d refers to a solvent which does not interact with starting materials, reagents, intermediates or products in a manner which adversely affects the yield of the desired product.
The parenthetical negative or positive sign used herein in the nomenclature denotes the direction plane polarized light is rotated by the particular stereoisomer.
The chemist of ordinary skill will recognize that certain compounds of this invention will contain one or more atoms which may be in a particular stereochemical or geometric configuration, giving rise to stereoisomers and configurational isomers. All such isomers and mixtures thereof are included in this invention. Hydrates of the compounds of this invention are also included as an aspect of this invention.
The chemist of ordinary skill will recognize that certain combinations of heteroatom-containing substituents listed in this invention define compounds which will be less stable under physiological conditions (e.g., those containing acetal or aminal linkages). Accordingly, such compounds are less preferred.
As used herein the term mono-N- or di-N,N-(C1-Cx)alkyl . . . refers to the (C1-Cx)alkyl moiety taken independently when it is di-N,N-(C1-Cx)alkyl . . . (x refers to integers).
As stated herein the ring formed by T may be optionally mono-substituted on carbon, such monosubstitution is in addition to Z and Z1.
Other features and advantages will be apparent from the specification and claims which describe the invention.
In general the compounds of this invention can be made by processes which include processes analogous to those known in the chemical arts, particularly in light of the description contained herein. Certain processes for the manufacture of the compounds of this invention are provided as further features of the invention and are illustrated by the following reaction Schemes. 
As a preliminary note, some substituents (e.g., R4) may best be prepared through conversion of another functional group at a point later in the synthetic sequence to the introduction of the substituent (e.g., R4 in Formulas VI and VII). When to use these conversion methods will vary depending on the nature of the substituent and the compound""s stability to the reaction conditions and can be readily determined by one skilled in the art. The method of preparation can also be readily determined by one skilled in the art using conventional methods of organic synthesis.
Also, some of the preparation methods described herein will require protection of remote functionality (i.e., carboxyl, hydroxyl). The need for these protecting groups will vary depending on the nature of the remote functionality and the conditions of the preparation methods. This need is readily determined by one skilled in the art. For a general description of protecting groups (e.g., halo(C1-C4)alkyl, (C1-C4)alkoxymethyl, arylmethyl and tri(C1-C4)alkylsilyl) and their use, see T. W. Greene, Protective Groups in Organic Synthesis, John Wiley and Sons, New York, 1991.
According to Reaction Scheme 1 the desired Formula I compounds wherein R1, R2, R3, R4, R9, R10, T, Z and Z1 are as described above (with Z and Z1 being appropriately protected when Z or Z1 are independently hydroxyl or carboxyl), X is oxy, and Y is carbonyl or methylene (depicted as Formula II compounds) may be prepared by acylating the appropriate amine with the corresponding Formula III compound (which has previously been hydrolyzed to the corresponding acid (where P is hydrogen)).
Generally, a Formula III compound is hydrolyzed in an aqueous alcoholic solvent such as methanol/water with a base such as potassium carbonate at a temperature of about 40xc2x0 C. to about 80xc2x0 C., preferably at reflux, for about 2 hours to about 18 hours. The resulting carboxylic acid is then combined with the appropriate amine in an aprotic solvent such as dimethylformamide in the presence of an amine base such as triethylamine and a coupling agent such as diethyl cyanophosphonate or propylphosphonic anhydride at a temperature of about 0xc2x0 C. to about 40xc2x0 C. for about 1 hour to about 6 hours.
Alternatively, the acid is combined with the appropriate amine in the presence of a carbodiimide (e.g., 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride) in a reaction inert solvent such as methylene chloride at a temperature of about 10xc2x0 C. to 40xc2x0 C. for about 2 to about 24 hours.
The desired Formula I compound wherein Z or Z1 are carboxyl may be prepared from the corresponding Formula II compound wherein Z or Z1 are alkoxycarbonyl (i.e., protected as described above) by hydrolysis. Alternatively, the hydrolysis step may be omitted resulting in the desired prodrugs.
Generally, a Formula II compound is hydrolyzed in an aqueous alcoholic solvent such as methanol/water with a base such as potassium carbonate at a temperature of about 40xc2x0 C. to about 80xc2x0 C., preferably at reflux, for about 2 hours to about 18 hours.
Prodrugs of Formula I compounds having a carboxyl group may be prepared by combining the acid with the appropriate alkyl halide in the presence of a base such as potassium carbonate in an inert solvent such as dimethylformamide at a temperature of about 15xc2x0 C. to about 100xc2x0 C. for about 1 hour to about 24 hours.
Alternatively, the acid is combined with the appropriate alcohol as solvent in the presence of a catalytic amount of acid such as concentrated sulfuric acid at a temperature of about 20xc2x0 C. to about 120xc2x0 C., preferably at reflux, for about 1 hour to about 24 hours.
The desired Formula I compound wherein Z is tetrazol-5-yl may be prepared from the corresponding Formula I compound wherein Z is carboxyl by converting the carboxyl group to a carboxamide group (Z is CONH2), dehydrating the carboxamide to the nitrile (Z is CN) and reacting the nitrile with an appropriate azide to form the tetrazole group.
Generally, the acid is converted to the imidazolide by reaction with carbonyl diimidazole in an aprotic solvent such as methylene chloride at a temperature of 15xc2x0 C. to about 40xc2x0 C. for about 30 minutes to about 4 hours, conveniently at room temperature for 1 hour. The resulting imidazolide is converted to the corresponding amide by bubbling ammonia gas into the reaction mixture at a temperature of 10xc2x0 C. to about 40xc2x0 C. for about 3 minutes to about 30 minutes, preferably at room temperature for about 5 minutes or until the reaction is complete by TLC analysis. The amide is converted to the nitrile by treatment with trifluoroacetic anhydride and triethylamine in an inert solvent such as methylene chloride at 0xc2x0 C. for about 25 minutes to 2 hours, preferably 30 minutes. Treatment of the nitrile with sodium azide and ammonium chloride in dimethylformamide at a temperature of about 90xc2x0 C. to about 130xc2x0 C. for about 7 hours to about 60 hours, preferably at a temperature of 120xc2x0 C. for 24 hours, yields the desired tetrazole.
The desired Formula I compound wherein Z is 4,5-dihydro-5-oxo-1,2,4-oxadiazol-3-yl may be prepared from the corresponding Formula I compound wherein Z is CN by converting the nitrile to the amide oxime and reacting the amide oxime with a carbonylating agent to form the corresponding 4,5-dihydro-5-oxo-1,2,4-oxadiazole derivative.
Generally, the nitrile is converted to the amide oxime by reaction with hydroxylamine hydrochloride in the presence of a base such as potassium carbonate in an alcoholic solvent at a temperature of about 60xc2x0 C. to about 11xc2x0 C. for about 5 hours to 24 hours, preferably in refluxing ethanol for about 18 hours. The amide oxime is converted to the corresponding 4,5-dihydro-5-oxo-1,2,4-oxadiazole derivative by reaction with carbonyidiimidazole and triethylamine in refluxing ethyl acetate for 24 hours.
The desired Formula I compound wherein Z is aminocarbonyl or (di)alkylaminocarbonyl may be prepared from the corresponding Formula I compounds where Z is alkoxycarbonyl by reaction with a complex of an amine salt and trimethylaluminum in an inert solvent such as toluene at a temperature of about 25xc2x0 C. to 110xc2x0 C. for about 2 to 24 hours. When the amine is ammonia, the reaction may yield either the nitrile or the carboxamide. The nitrile may be hydrolyzed to the primary carboxamide (Z is CONH2) by treatment with aqueous hydrogen peroxide in the presence of a base such as potassium carbonate in a cosolvent such as ethanol or dimethylsulfoxide at a temperature of 10xc2x0 C. to 100xc2x0 C. for about 2 to 24 hours. Alternatively, a Formula I compound wherein Z is aminocarbonyl or (di)alkylaminocarbonyl may be prepared by converting the acid to its imidazolide followed by conversion to the amide as described above for the preparation of a Formula I compound wherein Z is tetrazol-5-yl.
The desired Formula III compounds wherein R1, R2, R3, R4, R9 and R10 are as described above, X is oxy, Y is carbonyl or methylene and P is a known carboxyl protecting group (see reference above) may be prepared from the corresponding Formula IV compound by cyclization.
Generally, the Formula IV compound is combined with a base such as potassium carbonate in an alcoholic solvent such as ethanol at a temperature of about 10xc2x0 C. to about 40xc2x0 C., preferably ambient, for about 2 hours to about 18 hours.
The desired Formula IV compounds wherein R1, R2, R3, R4, R9 and R10 are as described above, X is oxy, Y is carbonyl or methylene and P is a known carboxyl protecting group (see reference above) may be prepared from the appropriate corresponding Formula V compound by acylation or alkylation as appropriate.
Generally, for those compounds wherein Y is carbonyl the appropriate Formula V compound is combined with the appropriate fumaryl chloride protected mono acid, such as fumaryl chloride monoalkyl ester, in a reaction-inert solvent such as methylene chloride at a temperature of about 10xc2x0 C. to about 50xc2x0 C., typically ambient, for about six to about eighteen hours. Generally, for those compounds wherein Y is methylene the appropriate Formula V compound is combined with the appropriately protected 4-halocrotonic acid, such as alkyl 4-halocrotonate, in the presence of a base such as potassium carbonate in a polar aprotic solvent such as dimethylformamide at a temperature of about 10xc2x0 C. to about 50xc2x0 C., typically ambient, for about 12 hours to about 72 hours.
The R4 substituent may be added to either the Formula VI or Formula V compounds by the following three alternative methods.
The desired Formula V compound wherein R1, R2, R3, R4, R9 and R10 are as described above may be prepared from the appropriate corresponding Formula VI compound by hydroxyalkylation (a modified Friedel-Crafts reaction).
Generally, the Formula VI compound is combined with a Lewis acid such as boron trichloride in a reaction-inert solvent such as benzene or toluene at a temperature of about ambient to about reflux for about 1 to about 6 hours under a nitrogen atmosphere to form an intermediate complex. The resulting complex is combined with the appropriately substituted benzaldehyde in a reaction-inert solvent such as benzene in the presence of an amine base such as triethylamine at a temperature of about 0xc2x0 C. to about 40xc2x0 C., typically ambient, for about 30 minutes to about 18 hours followed by aqueous acid cleavage of the boron moiety.
Alternatively, a Formula V compound wherein R1, R2, R3, R4, R9 and R10 are as described above may be prepared by treating a Formula VI compound wherein R4 is alkanoyl (optionally substituted as described above) with excess strong base, preferably 2.5 equivalents of n-butyllithium, in an anhydrous ethereal solvent, preferably tetrahydrofuran. The reaction is performed at a temperature of 0xc2x0 C. to about 50xc2x0 C. for about 1 hour to about 3 hours and the resulting dianion is reacted with the appropriate benzaldehyde. The resulting substituted benzhydrol derivative is then reacted with a reducing agent such as a borane-dimethyl sulfide complex in an ethereal solvent such as tetrahydrofuran at an elevated temperature, typically reflux resulting in the corresponding amine optionally substituted as described above for R4.
In yet another alternative method, the Formula V compounds wherein R1, R2, R3, R4, R9 and R10 are as described above may be prepared by treating the Formula VI compound, wherein R4 is alkoxycarbonyl, with excess strong base, preferably 2.4 equivalents of t-butyllithium, at a temperature of about xe2x88x9280xc2x0 C. to about 0xc2x0 C. The reaction is performed in an anhydrous ethereal solvent such as tetrahydrofuran for about 2 hours to about 4 hours and the resulting dianion is reacted with the appropriate benzaldehyde. The resulting benzhydrol derivative wherein R4 is alkoxycarbonyl is treated with aqueous acid and thereby converted to the Formula V compound, wherein R4 is hydrogen. This compound is transformed to the Formula V compound, wherein R4 is alkyl (optionally substituted as above), by reductive amination under conditions similar to those described for the preparation of the Formula VI compounds.
The desired Formula VI compounds wherein R1 and R2 are as described above and R4 is alkoxycarbonyl or alkanoyl may be prepared from acylation of the corresponding aniline with the appropriate alkyl chloroformate or acyl chloride, respectively, in a manner similar to that used in preparation of Formula IV compounds wherein Y is carbonyl.
The desired Formula VI compound wherein R1, R2, and R4 are as described above may be prepared from the appropriate corresponding aniline by reductive amination.
Generally, the aniline is reacted with the appropriate alkylaldehyde in a protic acidic solvent such as concentrated acetic acid at a temperature of about 10xc2x0 C. to about 50xc2x0 C., preferably ambient, for about 30 minutes to about four hours followed by reduction using for example sodium borohydride at a temperature of about 0xc2x0 C. to about 20xc2x0 C. for about 15 minutes to about four hours.
Altematively, the aniline is reacted with the appropriate alkylaldehyde in an aprotic solvent such as 1,2-dichloroethane in the presence of an acid such as acetic acid at a temperature of about 15xc2x0 C. to about 40xc2x0 C., preferably ambient temperature, for a period of about 1 to about 20 hours. The resulting compound is reduced using for example sodium triacetoxyborohydride at about xe2x88x9220xc2x0 C. to about ambient temperature for a period of about 1 to about 20 hours.
Alternatively, the desired Formula III compounds wherein R1, R2, R3, R4, R9 and R10 are as described above X is oxy, Y is carbonyl and P is a known carboxyl protecting group (see reference below) may also be prepared from the corresponding Formula VII compounds by reduction followed by cyclization.
Generally, the Formula VII compound is combined with a reducing agent such as sodium borohydride in methanol solvent at a temperature of 0xc2x0 C. to 30xc2x0 C. for about 15 minutes to about one hour. The resulting compound is cyclized with a base such as potassium carbonate in an alcoholic solvent such as ethanol at a temperature of about 10xc2x0 C. to about 40xc2x0 C., preferably ambient, for about 2 hours to about 18 hours.
The desired Formula VII compounds wherein R1, R2, R3, R9 and R10 are as described above, X is oxy, Y is carbonyl and P is a known carboxyl protecting group (see reference below) may be prepared from the appropriate corresponding Formula VIII compound by alkylation.
Generally, the Formula VIII compound is deprotonated with a base such as sodium hydride in a polar aprotic solvent such as dimethylformamide under a nitrogen atmosphere at a temperature of about 0xc2x0 C. to about 50xc2x0 C. for about 30 minutes to about 2 hours. Then the appropriate alkyl halide is added at a temperature of about 0xc2x0 C. to about 60xc2x0 C., typically ambient temperature, and reacted for about 30 minutes to about 24 hours.
The desired Formula VIII compounds wherein R1, R2, R3, R9 and R10 are as described above, X is oxy, Y is carbonyl and P is a known carboxyl protecting group (see reference above) may be prepared from the appropriate corresponding Formula IX compound by acylation.
Generally, the appropriate Formula IX compound is combined with the appropriate fumaryl chloride protected mono acid, such as fumaryl chloride monoalkyl ester, in a reaction-inert solvent such as methylene chloride at a temperature of about 10xc2x0 C. to about 50xc2x0 C., typically ambient, for about six to about eighteen hours.
The desired Formula IX compounds wherein R1, R2, R3, R9 and R10 are as described above may be prepared from the appropriate corresponding Formula VI compound wherein R4 is alkoxycarbonyl by directed ortho lithiation followed by hydrolysis of the amide.
Generally, the appropriate Formula VI compound where R4 is alkoxycarbonyl is treated with excess strong base, preferably greater than 2 equivalents of sec-butyllithium or tert-butyllithium, in an anhydrous ethereal solvent, preferably tetrahydrofuran, under a nitrogen atmosphere at a temperature of xe2x88x9240xc2x0 C. to 10xc2x0 C., preferably 0xc2x0 C., for about 1 hour to about 5 hours. The resulting dianion is then reacted with the Weinreb amide of the appropriate benzoic acid at a temperature of xe2x88x92100xc2x0 C. to 0xc2x0 C., preferably xe2x88x9278xc2x0 C., for about 30 minutes to about 24 hours while gradually warming to ambient temperature. The resulting benzophenone is treated with aqueous acid such as hydrochloric acid in a co-solvent such as tetrahydrofuran or dimethoxyethane at a temperature of 25xc2x0 C. to 100xc2x0 C., preferably at reflux, for about 5 hours to about 48 hours.
Alternatively the desired Formula IX compounds may be prepared from the corresponding isatoic anhydride by conversion to the Weinreb amide which is condensed with the appropriate metallated benzene derivative.
Generally the isatoic anhydride is reacted with O,N-dimethylhydroxylamine hydrochloride in the presence of a base such as triethylamine in water and a cosolvent such as dioxan or ethanol at a temperature of 50xc2x0 C. to 100xc2x0 C., preferably at reflux for about 1 to 5 hours. The Weinreb amide is deprotonated by a strong base such as butyllithium under a nitrogen atmosphere in an inert solvent such as tetrahydrofuran at a temperature of xe2x88x9278xc2x0 C. to xe2x88x9240xc2x0 C. for about 0.5 to 2 hours, then treated with a solution of the appropriate metallated, typically lithiated, phenyl derivative in an inert solvent such as diethyl ether at a temperature of xe2x88x92100xc2x0 C. to 0xc2x0 C., preferably xe2x88x9278xc2x0 C., for about 0.5 hours to about 24 hours while gradually warming to 25xc2x0 C.
According to Reaction Scheme 2 the desired Formula I compounds wherein R1, R2, R3, R4, R9 and R10 are as described above, X is thio, Y is carbonyl or methylene and Z is carboxyl (depicted as Formula X compounds) may be prepared by acylating the appropriate amine with the corresponding Formula XI or XII compound. Generally this reaction may be performed as describe above for the Formula II compounds.
The desired Formula XI compounds wherein R1, R2, R3, R4, R9 and R10 are as described above, X is thio, Y is methylene may be prepared from the appropriate corresponding Formula XII compound where Y is carbonyl by a sequential reduction/oxidation procedure.
Generally the Formula XII compound is fully reduced using for example a borane-methyl sulfide complex in a reaction-inert solvent such as tetrahydrofuran at a temperature of about 20xc2x0 C. to about 8xc2x0 C., preferably at ambient temperature, for about 1 hours to about 24 hours. The resulting alcohol is then oxidized to the Formula XI compound using for example a two step procedure involving first a Swern oxidation followed by oxidation with buffered sodium chlorite in acetonitrile and aqueous hydrogen peroxide at a temperature of about xe2x88x9210xc2x0 C. to about 25xc2x0 C. for about 30 minutes to about 4 hours. Or alternatively, the alcohol is directly oxidized to the acid using t-butyl hydroperoxide and cetyl trimethyl ammonium sulfate in an aqueous mixture at pH greater than 13.
The desired Formula XII compound wherein R1, R2, R3, R4, R9 and R10 are as described above, may be prepared from the appropriate corresponding Formula XIII compound by alkylation followed by epimerization and finally hydrolysis.
Generally, the Formula XIII compound is combined with a base such as lithium diisopropylamide in a reaction-inert solvent such as cyclohexane/tetrahydrofuran at a temperature of about xe2x88x92100xc2x0 C. to about xe2x88x9220xc2x0 C. under nitrogen for about 30 minutes to about 3 hours followed by addition of a suitable alkyl haloacetate such as t-butyl bromoacetate and mixing for about 2 to about 24 hours at a temperature of about 10xc2x0 C. to about 40xc2x0 C., preferably ambient. The alkylated product is epimerized to exclusively the trans isomers using a base such as potassium carbonate in an alcoholic solvent such as methanol for 1 hour to 6 hours at a temperature of about 40xc2x0 C. to about 80xc2x0 C., preferably at 60xc2x0 C. The ester may be hydrolyzed by treatment with an acid such as trifluoroacetic acid in a reaction-inert solvent such as dichloromethane in the case of a t-butyl ester.
The desired Formula XIII compound wherein R1, R2, R3, R4, R9 and R10 are as described above, may be prepared from the appropriate corresponding Formula XIV compound by coupling under carbodiimide conditions.
Generally, the Formula XIV compound is combined with a suitable carbodiimide such as 1-(3dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride in a reaction-inert solvent such as dichloromethane at a temperature of about 10xc2x0 C. to about 50xc2x0 C., conveniently at ambient temperature, for about 5 hours to about 24 hours.
The desired Formula XIV compound wherein R1, R2, R3, R4, R9 and R10 are as described above, may be prepared from the appropriate corresponding Formula V compound by a solvolytic displacement reaction.
Generally, the Formula V compound may be combined with mercaptoacetic acid under aqueous acidic conditions at a temperature of about 60xc2x0 C. to about 120xc2x0 C., conveniently at reflux, for about 2 to about 6 hours.
Alternatively, the desired Formula XII compounds wherein R1, R2, R3, R4, R9 and R10 are as described above may be prepared from the appropriate corresponding Formula V compound by a solvolytic displacement reaction with mercaptosuccinic acid, cyclization to the lactam and epimerization.
Generally, the Formula V compound and mercaptosuccinic acid are combined in a carboxylic acid solvent such as propionic acid with a means to remove water, such as a nitrogen sweep across the head space of the reaction vessel, and heated to about 100xc2x0 C. to about 140xc2x0 C. for about 12 to 72 hours. The cyclized product is epimerized to the trans isomers by treatment in an inert solvent such as tetrahydrofuran with a base such as a metal alkoxide base in the corresponding alcohol solvent, preferably sodium methoxide in methanol, at about ambient temperature to reflux temperature for a period of about 1 to about 24 hours.
It is reiterated that some substituents (e.g., R4) may best be prepared through conversion of another functional group at a point later in the synthetic sequence to the introduction of the substituents (e.g., R4 in Formulas VI and VII). When to use these conversion methods will vary depending on the nature of the substituent and the compound""s stability to the reaction conditions and can be readily determined by one skilled in the art. The method of preparation can also be readily determined by one skilled in the art using conventional methods of organic synthesis.
The starting materials and reagents for the above described reaction schemes (e.g., 4-haloaniline, substituted benzaldehyde, furmaric acid monoethyl ester, amino acid esters, prodrug residues, protected forms) are readily available or can be easily synthesized by those skilled in the art using conventional methods of organic synthesis. The preparation of certain compounds disclosed in PCT Publication WO 96/09827 may be used as an aid in preparing certain starting materials. In addition, some of the intermediates used herein to prepare the compounds of this invention are, or are related to, or are derived from amino acids found in nature, in which there is a large scientific interest and commercial need, and accordingly many such intermediates are commercially available or are reported in the literature or are easily prepared from other commonly available substances by well known methods which are reported in the literature.
The methods described above are useful to prepare the compounds of this invention, other methods may be described in the experimental section.
The compounds of Formula I have asymmetric carbon atoms and therefore are enantiomers or diastereomers. Diasteromeric mixtures can be separated into their individual diastereomers on the basis of their physical chemical differences by methods known per se., for example, by chromatography and/or fractional crystallization. Enantiomers can be separated by converting the enantiomeric mixture into a diasteromeric mixture (e.g., ester or salt) by reaction with an appropriate optically active compound (e.g., alcohol or amine), separating the diastereomers and converting (e.g., hydrolyzing or acidifying) the individual diastereomers to the corresponding pure enantiomers. All such isomers, including diastereomers and enantiomers are considered as part of this invention.
Some of the compounds of this invention, where for example Z contains an acid group, are acidic and they form a salt with a pharmaceutically acceptable cation. All such salts are within the scope of this invention and they can be prepared by conventional methods. For example, they can be prepared simply by contacting the acidic and basic entities, usually in a stoichiometric ratio, in either an aqueous, non-aqueous or partially aqueous medium, as appropriate. The salts are recovered either by filtration, by precipitation with a non-solvent followed by filtration, by evaporation of the solvent, or, in the case of aqueous solutions, by lyophilization, as appropriate.
Some of the compounds of this invention where, for example Y is methylene or Z contains an amine group are basic, and they form a salt with a pharmaceutically acceptable anion. All such salts are within the scope of this invention and they can be prepared by conventional methods. For example, they can be prepared simply by contacting the acidic and basic entities, usually in a stoichiometric ratio, in either an aqueous, non-aqueous or partially aqueous medium, as appropriate. The salts are recovered either by filtration, by precipitation with a non-solvent followed by filtration, by evaporation of the solvent, or, in the case of aqueous solutions, by lyophilization, as appropriate.
In addition, when the compounds of this invention form hydrates or solvates they are also within the scope of the invention.
The utility of the compounds of the present invention as medical agents in the treatment of diseases (such as are detailed herein) in mammals (e.g., humans) is demonstrated by the activity of the compounds of this invention in conventional assays and the in vitro and in vivo assays described below. Such assays also provide a means whereby the activities of the compounds of this invention can be compared with the activities of other known compounds. The results of these comparisons are useful for determining dosage levels in mammals, including humans, for the treatment of such diseases.
The compounds of this invention are adapted to therapeutic use as agents that lower plasma LDL cholesterol levels in mammals, particularly humans. Since the concentration of cholesterol in blood is closely related to the development of cardiovascular, cerebral vascular or peripheral vascular disorders, these compounds, by virtue of their hypocholesterolemic action, prevent, arrest and/or regress atherosclerosis.
The hypocholesterolemia activity of these compounds can be determined by assessing the effect of these compounds on the action of squalene synthetase by measuring the overall conversion of [1-3H]famesyl pyrophosphate ([3H]FPP) to [3H]squalene, essentially as previously described in Meth. Enzymol. 110, 359, 1985 using the anaerobic atmosphere generating oxygen consumption system described in Analyt. Biochem. 203, 310, 1992, in comparison to known controls (e.g., zaragozic add A).
Briefly, to a 3 xcexcl volume of either DMSO (control) or DMSO containing compound, are added 47 xcexcl of Squalene Synthetase Cofactor/Substrate solution (SQS Cofactor/Substrate solution contains 50 mM KxPO4 (pH 7.4), 5.0 mM MgCl2, 411 xcexcM NADP+, 3.4 mM glucose-6-phosphate, 20 U/ml glucose-6-phosphate dehydrogenase, 15 mM NaF, 78.1 mM sodium ascorbate, 31.3 U/ml ascorbate oxidase, and 1.56 times the indicated final concentrations of [3H]FPP (sp. act. 380/pmol)) and 25 xcexcl of PMED buffer (PMEB buffer contains 50 mM KxPO4 (pH 7.4), 5 mM MgCl2, 1.0 mM EDTA, 5.0 mM dithiothreitol) containing 1 mg/ml microsomal protein [Final assay concentrations: 48 mM KxPO4 (pH 7.4), 4.8 mM MgCl2, 0.33 mM EDTA, 1.67 mM DTT, 258 xcexcM NADP+, 2.1 mM glucose-6-phosphate, 0.95U glucose-6-phosphate dehydrogenase, 9.5 mM NaF, 50 mM sodium ascorbate, 1.5U ascorbate oxidase, 4% DMSO, and 5.1 xcexcM [3H]famesyl pyrophosphate]. After incubation at 37xc2x0 C. for 30 min, enzymatic reactions are terminated by sequential addition of 40 xcexcl, 10 M NaOH, 40 xcexcl EtOH, 10 xcexcl of 2 mg/ml squalene in chloroform. After saponification (90 minutes, 37xc2x0 C.), aliquots were applied to silica gel TLC and newly formed squalene separated from unreacted substrate by chromatography in toluene-ethyl acetate (9:1). The squalene band is visualized with iodine vapors, removed, and immersed in Aqualsol-2 liquid scintillation fluid. Squalene synthetase activity is expressed as pmoles of squalene formed from famesyl pyrophosphate per min of incubation at 37xc2x0 C. per mg microsomal protein, based on the stoichiometry of the reaction whereby two moles of [3H]famesyl pyrophosphate react to form one mole of [3H]squalene and half of the radiolabel is lost from the C-1 position of the prenylating [3H]famesyl pyrophosphate due to 1-pro-S hydrogen release. Rat hepatic microsomes are used as the source of squalene synthetase activity as described by Harwood et al (J. Lipid Res. 34, 377, 1993). Briefly, hepatic tissues are rinsed in phosphate buffered saline and immediately homogenized at 4xc2x0 C. in PMED buffer, using a Dounce tissue homogenizer. Homogenates are centrifuged at 10,000xc3x97g for 20 min at 4xc2x0 C. and the resultant supernatants are centrifuged at 178,000xc3x97g for 90 min at 4xc2x0 C. Microsomal pellets are resuspended in PMED buffer by a Potter-Elvehjem pestle and stored frozen in liquid N2 until use. For such preparations, there is no notable loss in enzyme activity within 3 months.
The hypercholesterolemic treating activity of these compounds may be demonstrated by methods based on standard procedures. For example, the in vivo activity of these compounds in inhibiting cholesterol biosynthesis may be determined by the procedure of Hughes et. al. 1977 J. Biol Chem. 252: 548.
Activity of these compounds can be determined by the amount of hypocholesterolemic agent that reduces hepatic cholesterol biosynthesis, relative to control, in male CD1 mice. Male CD1 mice are maintained on a cholesterol-free diet in a 12 hr light/12 hr dark cycle. At mid light cycle animals are administered a 0.5 mL oral bolus of saline containing 0.25% methyl cellulose, 0.6% Tween 80 and 10% ethanol (control animals) or an oral bolus that contained in addition the desired concentration of compound to be tested. One hour following bolus administration the animals receive an intraperitoneal injection (0.15 ml) of [14C]-mevalonolactone dissolved in water (0.5 uCi/animal). One hour following the injection of radioactivity animals are sacrificed, livers excised, saponified ((2.5 M KOH, 2 h) 60xc2x0 C.) and extracted with petroleum ether and ethanol. After saponification, the radioactivity is measured. Total hepatic radioactivity is calculated based on measured liver weights. The degree of cholesterol biosynthesis inhibition is expressed as a percentage of the total radioactivity in treated vs control animals. The above assay carried out with a range of doses of test compounds allow the determination of an ED50 value for the in vivo reduction of hepatic cholesterol biosynthesis.
The hypercholesterolemic and hypertriglyceremia treating activity of these compounds may also be demonstrated by determining the amount of agent required to reduce cholesterol levels and/or triglycerides. For example LDL cholesterol levels may be measured in the plasma of certain mammals, for example marmosets that possess a plasma lipoprotein profile similar to that of humans (Crook et al. Arteriosclerosis 10, 625, 1990). Cholesterol synthesis inhibitors, for example HMG-CoA reductase inhibitors and the squalene synthetase inhibitor zaragozic acid A, lower plasma cholesterol concentrations in this species (Baxter, et al., J. Biol. Chem. 267, 11705, 1992). Adult marmosets are assigned to treatment groups so that each group has a similar meanxc2x1SD for total plasma cholesterol concentration. After group assignment, marmosets are dosed daily with compound as a dietary admix or by intragastric intubation for from one to eight weeks. Control marmosets receive only the dosing vehicle. Plasma total, LDL and HDL cholesterol values can be determined at any point during the study by obtaining blood from an antecubital vein and by separating plasma lipoproteins into their individual subclasses by density gradient centrifugation, and by measuring cholesterol concentration as previously described (Crook, et al., Arteriosclerosis 10, 625, 1990). An analogous measurement of triglycerides may be made to determine the effect on hypertriglyceremia using for example, an enzymatic assay kit (Wako Pure Chemical Industries).
Anti-atherosclerosis effects of the compounds can be determined by the amount of agent required to reduce the lipid deposition in the rabbit aorta. Male New Zealand White rabbits are fed a diet containing 0.4% cholesterol and 5% peanut oil for 4 days (meal-fed once per day). Rabbits are bled from the marginal ear vein and total plasma cholesterol values are determined from these samples. The rabbits are then assigned to treatment groups so that each group has a similar meanxc2x1s.d. for total plasma cholesterol concentration. After group assignment, rabbits are dosed daily with compound given as a dietary admix or on a small piece of gelatin based confection. Control rabbits receive only the dosing vehicle be it the food or the gelatin confection. The cholesterol/peanut oil diet is continued along with the compound administration throughout the study. Plasma cholesterol values can be determined at any point during the study by obtaining blood from the marginal ear vein. After 5 months, the rabbits are sacrificed and the aortae are removed from the thoracic arch to the branch of the iliac arteries. The aortae are cleaned of adventitia, opened longitudinally and then stained with Sudan IV as described by Holman et al. (Lab. Invest. 1958, 7, 42-47). The percent of the surface area stained is quantitated by densitometry using an Optimas Image Analyzing System (Image Processing Systems). Reduced lipid deposition is indicated by a reduction in the percent surface area stained in the drug group in comparison with the control rabbits.
Administration of the compounds of this invention for the treatment of hypercholesterolemia, hypertriglyceridemia or atherosclerosis can be via any method which delivers the compound to the intestine and the liver. These methods include oral routes, parenteral, intraduodenal routes etc.
Thus, for example, in one mode of administration a compound of this invention may be administered once at night prior to sleep. Alternatively the compounds may be administered twice or three times daily with or without meals. In any event the amount and timing of compound(s) administered will, of course, be dependent on the subject being treated, on the severity of the affliction, on the manner of administration and on the judgment of the prescribing physician. Thus, because of patient to patient variability, the dosages given below are a guideline and the physician may titrate doses of the compound to achieve the plasma cholesterol lowering that he/she considers appropriate for the patient. In considering the degree of hypocholesterolemic activity desired, the physician must balance a variety of factors such as starting cholesterol level, other cardiovascular risk factors, presence of preexisting disease, and age of the patient and his/her motivation. Those skilled in the art will know of the National Cholesterol Education program guidelines for treatment of hypercholesterolemia (Circulation 1991; 83:2154)
In general an effective dosage for the compounds described above for the treatment of hypercholesterolemia, hypertriglyceridemia or atherosclerosis is in the range of 0.0005 to 50 mg/kg/day, preferably 0.001 to 25 mg/kg/day, most preferably 0.005 to 5 mg/kg/day. For an average 70 kg human, this would amount to 0.000035 to 3.5 g/day, preferably 0.00007 to 1.75 g/day, most preferably 0.00035 to 0.35 g/day.
The compounds of this invention are also effective as antifungal agents, useful in the curative or prophylactic treatment of fungal infections in animals such as mammals, including humans. For example, they are useful in treating superficial fungal infections in man caused by, among other organisms, species of Candida, Trichophyton, Microsporum or Epidermophyton, or in mucosal infections caused by Candida albicans (e.g. thrush and vaginal candidiasis). They can also be used in the treatment of systemic fungal infections caused by, for example, species of Candida (e.g. Candida albicans), Cryptococcus neoformans, Aspergillus flavus, Aspergillus fumigatus, Coccidioides, Paracoccidioides, Histoplasma or Blastomyces.
The in vitro evaluation of the antifungal activity of the compounds of this invention can be performed by determining the minimum inhibitory concentration (MIC), which is the concentration of the test compounds, in a suitable medium, at which growth of the particular micro-organism fails to occur. In practice, a series of agar plates, or liquid medium in microtiter plates, each having the test compound incorporated at a particular concentration, is inoculated with a standard culture of, for example, Cryptococcus neoformans, and each plate is then incubated for 48 hours at 37xc2x0 C. The plates are then examined for the presence or absence of growth of the fungus and the appropriate MIC value is noted. Other micro-organisms used in such tests can include Candida Albicans, Aspergillus fumigatus, Trichophyton spp., Microsporum spp., Epidermophyton floccosum, Coccidioides immitis and Torulopsis glabrata. 
The in vivo evaluation of the compounds as antifungal agents can be carried out at a series of dose levels by intraperitoneal or intravenous injection, or by oral administration, to mice or rats which are inoculated with, e.g. a strain of Candida albicans, Aspergillus fumigatus or Cryptococcus neoformans. Activity may be based on the number of survivors from a treated group of mice after the death of an untreated group of mice.
For Candida spp. infection models the dose level at which the compounds provides 50% protection against the lethal effect of the infection (PD50) is also assessed.
For Aspergillus spp. infection models the number of mice cured of the infection after a set dose allows further assessment of activity.
For Cryptococcus spp. infection models the number of colony forming units existing after a set dose is assessed and compared with control to determine compound efficacy. A preliminary assessment of potential liver toxicity may also be made on the basis of increase in liver weight relative to control.
As an antifungal treatment the compounds of this invention are administered to mammals (e.g., humans) by conventional methods.
For human antifungal use, the compounds of this invention can be administered alone, but will generally be administered in admixture with a pharmaceutical carrier selected with regard to the intended route of administration and standard pharmaceutical practice. For example, they can be administered orally in the form of tablets containing such excipients as starch or lactose, or in capsules or ovules either alone or in admixture with excipients, or in the form of elixirs, solutions or suspensions containing flavoring or coloring agents. They can be injected parenterally, for example, intravenously, intramuscularly or subcutaneously. For parenteral administration, they are best used in the form of a sterile aqueous solution which may contain other substances, for example, enough salts or glucose to make the solution isotonic with blood.
For oral and parenteral antifungal administration to human patients, the daily dosage level of the compounds of this invention for antifungal treatments will be from 0.01 to 20 mg/kg, preferably 0.5 to 5 mg/kg, (in single or divided doses) when administered by either the oral or parenteral route. Thus tablets or capsules of the compounds will contain from 5 mg to 0.5 g of active compound for administration singly or two or more at a time, as appropriate. The physician in any event will determine the actual dosage which will be most suitable for an individual patient and it will vary with the age, weight and response of the particular patient. The above dosages are exemplary of the average case; there can, of course, be individual instances where higher or lower dosage ranges are merited, and such are within the scope of this invention.
Alternatively, the antifungal compounds of this invention can be administered in the form of a suppository pessary, or they may be applied topically in the form of a lotion, solution, cream, ointment or dusting powder. For example, they can be incorporated into a cream consisting an aqueous emulsion of polyethylene glycols or liquid paraffin; or they can be incorporated, at a concentration between 1 to 10%, into an ointment comprising a white wax or white soft paraffin base together with such stabilizers and preservatives as may be required.
Since the compounds of this invention are cholesterol biosynthesis inhibitors they can also lower the levels of Apolipoprotein E isoform 4 circulating in the bloodstream. Apolipoprotein E isoform 4 that is made in the brain also circulates through the central nervous system and is present in the cerebrospinal fluid. Compounds of this invention are useful for the treatment of Alzheimer""s disease.
Apolipoprotein E isoform 4 (xe2x80x9cApoE isoform 4xe2x80x9d) is an apolipoprotein which is the gene product of the apolipoprotein E Type 4 allele and is carried in the bloodstream on lipoproteins including LDL. Possession of one or two copies of the apolipoprotein E type 4 allele has been linked to a greatly increased risk of developing Alzheimer""s disease. In the liver, low density lipoprotein receptors (LDL receptors) are responsible for absorbing and taking up from the bloodstream various lipoproteins including some of those containing ApoE isoform 4. LDL receptors are regulated by gene repressors derived from cholesterol that suppress the transcription of the LDL-receptor. Inhibition of cholesterol biosynthesis reduces the presence of these cholesterol-derived LDL gene repressors. This relieves the suppression of the production of the LDL receptor, leading to production of additional LDL receptors in the liver, which in turn, remove additional amounts of lipoproteins including ApoE Type 4 containing lipoproteins from the bloodstream. The Alzheimer""s disease treating activity of these compounds can be determined by assessing the effect of these compounds on the action of squalene synthetase by measuring the overall conversion of [1-3H]famesyl pyrophosphate to [3H]squalene, essentially as previously described in Meth. Enzymol. 110, 359, 1985 using the anaerobic atmosphere generating oxygen consumption system described in Analyt. Biochem. 203, 310,1992, in comparison to known controls (e.g., zaragozic acid A). This assay is described more fully above.
The Alzheimer""s disease treating activity of these compounds may also be demonstrated by determining the amount of agent required to reduce cholesterol levels, for example LDL cholesterol levels, in the plasma of certain mammals, for example marmosets that possess a plasma lipoprotein profile similar to that of humans (Crook et al. Arteriosclerosis 10, 625,1990). Cholesterol synthesis inhibitors, for example HMG-CoA reductase inhibitors and the squalene synthetase inhibitor zaragozic acid A, lower plasma cholesterol concentrations in this species (Baxter, et al., J. Biol. Chem. 267, 11705, 1992). This assay is described more fully above.
The compounds of this invention may be administered using conventional methods for the treatment of Alzheimer""s disease. In general an effective dosage for the squalene synthetase inhibitors of this invention for the treatment of Alzheimer""s disease is in the range for adults of from about 1 mg to 1000 mg (preferably 5 to 100 mg,) per day which may be given in a single dose or in two to four divided doses. Higher doses may be favorably employed as required.
Since the compounds of this invention are squalene synthesis inhibitors they are effective for the treatment of acne vulgaris. Squalene is a major component of sebum, comprising about 12% of sebum in adults. The severity of acne vulgaris correlates directly with the sebum secretion rate and several compounds which decrease sebum secretion rate have been shown to improve acne. By inhibiting squalene the compounds of this invention can decrease the sebum secretion rate and thereby treat acne.
The concentration of squalene in sebum increases four-fold after puberty and it is believed that this increase in squalene concentration alone or in concert with other changes in sebum composition or sebum secretion rate facilitate the development of acne. The compounds of this invention are useful in preventing or mollifying acne by reducing the percentage and total amount of squalene in sebum.
In addition to reducing squalene levels in sebum, by limiting the production of epoxides, the sebum may become less inflammatory (through metabolic action of the ever-present P. acnes). The compounds of this invention may therefore provide a dual effect to combat acne and thus constitute a new, better treatment for acne than current keratolytic and anti-androgen therapies.
The anti-acne activity of the compounds of this invention may be demonstrated by testing the in vitro effects of the compounds in human sebaceous gland culture using conditions analogous to those described in FEBS Letters 200(1), 173-176 (1986) and J. Cell Science 95, 125136 (1990). Thus, the human sebaceous gland culture may be incubated with the test compound and subsequent sebum production and qualitative changes of sebum composition measured over a short period of time and compared with controls and other actives.
For the treatment of acne the compounds of this invention may be administered by conventional methods. For the treatment of acne each dosage unit will preferably contain 0.001 mg to 1000 mg, advantageously 0.01 mg to 400 mg, of active ingredient. The daily dosage as employed for adult human treatment will preferably range from 0.001 mg to 5000 mg of active ingredient, most preferably from 0.01 mg to 2000 mg which may be administered in 1 to 4 daily doses, for example, depending on the route of administration and on the condition of the patient.
The compounds of this invention may also be used in conjunction with other pharmaceutical agents. For example, they may be used in combination with other cholesterol synthesis inhibitors and cholesterol absorption inhibitors as described below and other cholesterol lowering agents such as fibrates, niacins, ion-exchange resins, antioxidants, ACAT inhibitors and bile acid sequestrants as a means of lowering plasma cholesterol and as a means of treating atherosclerosis. Alternatively, the compound of this invention may be used in conjunction with an antifungal agent such as those conventional in the art (e.g., lanosterol demethylase inhibitor) for the treatment of a fungal infection. Alternatively, they may be used in conjunction with another anti-acne agent (e.g. a topical or oral antibiotic both of which are conventional in the pharmaceutical industry). In combination therapy treatment, both the compounds of this invention and the other drug therapies are administered to mammals (e.g., humans) by conventional methods.
In particular, other cholesterol absorption inhibitors and cholesterol synthesis inhibitors are described further below.
Other cholesterol absorption inhibitors are described for example, in PCT WO 94/00480.
Any HMG-CoA reductase inhibitor may be used as the second compound in the combination aspect of this invention. The term HMG-CoA reductase inhibitor refers to compounds which inhibit the bioconversion of hydroxymethylglutaryl-coenzyme A to mevalonic acid catalyzed by the enzyme HMG-CoA reductase. Such inhibition is readily determined by those skilled in the art according to standard assays (e.g., Meth. Enzymol. 1981; 71:455509 and references cited therein). A variety of these compounds are described and referenced below however other HMG-CoA reductase inhibitors will be known to those skilled in the art. U.S. Pat. No. 4,231,938 (the disclosure of which is hereby incorporated by reference) discloses certain compounds isolated after cultivation of a microorganism belonging to the genus Aspergillus, such as lovastatin. Also, U.S. Pat. No. 4,444,784 (the disclosure of which is hereby incorporated by reference) discloses synthetic derivatives of the aforementioned compounds, such as simvastatin. Also, U.S. Pat. No. 4,739,073 (the disclosure of which is incorporated by reference) discloses certain substituted indoles, such as fluvastatin. Also, U.S. Pat. No. 4,346,227 (the disclosure of which is incorporated by reference) discloses ML-236B derivatives, such as pravastatin. Also, EP491226A (the disclosure of which is incorporated by reference) discloses certain pyridyldihydroxyheptenoic acids, such as rivastatin. In addition, U.S. Pat. No. 5,273,995 (the disclosure of which is incorporated by reference) discloses certain 6-[2-(substituted-pyrrol-1-yl)alkyl]pyran-2-ones such as atorvastatin.
Any HMG-CoA synthase inhibitor may be used as the second compound in the combination aspect of this invention. The term HMG-CoA synthase inhibitor refers to compounds which inhibit the biosynthesis of hydroxymethylglutaryl-coenzyme A from acetyl-coenzyme A and acetoacetyl-coenzyme A, catalyzed by the enzyme HMG-CoA synthase. Such inhibition is readily determined by those skilled in the art according to standard assays (Meth Enzymol. 1975; 35:155-160: Meth. Enzymol. 1985; 110:19-26 and references cited therein). A variety of these compounds are described and referenced below however other HMG-CoA synthase inhibitors will be known to those skilled in the art. U.S. Pat. No. 5,120,729 (the disclosure of which is hereby incorporated by reference) discloses certain beta-lactam derivatives. U.S. Pat. No. 5,064,856 (the disclosure of which is hereby incorporated by reference) discloses certain spiro-lactone derivatives prepared by culturing a microorganism (MF5253). U.S. Pat. No. 4,847,271 (the disclosure of which is hereby incorporated by reference) discloses certain oxetane compounds such as 11-(3-hydroxymethyl-4-oxo-2-oxetayl)3,5,7-trimethyl-2,4-undeca-dienoic acid derivatives.
Any compound that decreases HMG-CoA reductase gene expression may be used as the second compound in the combination aspect of this invention. These agents may be HMG-CoA reductase transcription inhibitors that block the transcription of DNA or translation inhibitors that prevent translation of mRNA coding for HMG-CoA reductase into protein. Such compounds may either affect transcription or translation directly, or may be biotransformed to compounds that have the aforementioned activities by one or more enzymes in the cholesterol biosynthetic cascade or may lead to the accumulation of an isoprene metabolite that has the aforementioned activities. Such regulation is readily determined by those skilled in the art according to standard assays (Meth. Enzymol. 1985; 110:9-19). Several compounds are described and referenced below however other inhibitors of HMG-CoA reductase gene expression will be known to those skilled in the art. U.S. Pat. No. 5,041,432 (the disclosure of which is incorporated by reference) discloses certain 15-substituted lanosterol derivatives. Other oxygenated sterols that suppress synthesis of HMG-CoA reductase are discussed by E. I. Mercer (Prog.Lip. Res. 1993;32:357-416).
Any squalene epoxidase inhibitor may be used as the second compound in the combination aspect of this invention. The term squalene epoxidase inhibitor refers to compounds which inhibit the bioconversion of squalene and molecular oxygen into squalene-2,3-epoxide, catalyzed by the enzyme squalene epoxidase. Such inhibition is readily determined by those skilled in the art according to standard assays (Biochim. Biophys. Acta 1984; 794:466471). A variety of these compounds are described and referenced below however other squalene epoxidase inhibitors will be known to those skilled in the art. U.S. Pat. Nos. 5,011,859 and 5,064,864 (the disclosures of which are incorporated by reference) disclose certain fluoro analogs of squalene. EP publication 395,768 A (the disclosure of which is incorporated by reference) discloses certain substituted allylamine derivatives. PCT publication WO 9312069 A (the disclosure of which is hereby incorporated by reference) discloses certain amino alcohol derivatives. U.S. Pat. No. 5,051,534 (the disclosure of which is hereby incorporated by reference) discloses certain cyclopropyloxy-squalene derivatives.
Any squalene cyclase inhibitor may be used as the second component in the combination aspect of this invention. The term squalene cyclase inhibitor refers to compounds which inhibit the bioconversion of squalene-2,3-epoxide to lanosterol, catalyzed by the enzyme squalene cyclase. Such inhibition is readily determined by those skilled in the art according to standard assays (FEBS Lett. 1989;244:347-350.). In addition, the compounds described and referenced below are squalene cyclase inhibitors, however other squalene cyclase inhibitors will also be known to those skilled in the art. PCT publication 9410150 (the disclosure of which is hereby incorporated by reference) discloses certain 1,2,3,5,6,7,8,8xcex1-octahydro-5,5,8xcex1(beta)-trimethyl-6-isoquinolineamine derivatives, such as N-trifluoroacetyl-1,2,3,5,6,7,8,8xcex1-octahydro-2-allyl-5,5,8xcex1(beta)-trimethyl-6(beta)-isoquinolineamine. French patent publication 2697250 (the disclosure of which is hereby incorporated by reference) discloses certain beta, beta-dimethyl-4-piperidine ethanol derivatives such as 1-(1,5,9-trimethyidecyl)-beta,beta-dimethyl-4-piperidineethanol.
Any combined squalene epoxidase/squalene cyclase inhibitor may be used as the second component in the combination aspect of this invention. The term combined squalene epoxidase/squalene cyclase inhibitor refers to compounds that inhibit the bioconversion of squalene to lanosterol via a squalene-2,3-epoxide intermediate. In some assays (certain experimental conditions) it is not possible to distinguish between squalene epoxidase inhibitors and squalene cyclase inhibitors, however, these assays (experimental conditions) are recognized by those skilled in the art. Thus, inhibition by combined squalene epoxidase/squalene cyclase inhibitors is readily determined by those skilled in art according to the aforementioned standard assays for squalene cyclase or squalene epoxidase inhibitors. A variety of these compounds are described and referenced below however other squalene epoxidase/squalene cyclase inhibitors will be known to those skilled in the art. U.S. Pat. Nos. 5,084,461 and 5,278,171 (the disclosures of which are incorporated by reference) disclose certain azadecalin derivatives. EP publication 468,434 (the disclosure of which is incorporated by reference) discloses certain piperidyl ether and thio-ether derivatives such as 2-(1-piperidyl)pentyl isopentyl sulfoxide and 2-(1-piperidyl)ethyl ethyl sulfide. PCT publication WO 9401404 (the disclosure of which is hereby incorporated by reference) discloses certain acyl-piperidines such as 1-(1-oxopentyl-5-phenylthio) 4(2-hydroxy-1-methyl)ethyl)piperidine. U.S. Pat. No. 5,102,915 (the disclosure of which is hereby incorporated by reference) discloses certain cyclopropyloxy-squalene derivatives.
Any lanosterol demethylase inhibitor may be used as the second compound in the combination aspect of this invention. The term lanosterol demethylase inhibitor refers to compounds which inhibit the 14-demethylation of lanosterol catalyzed by the enzyme lanosterol demethylase. Such inhibition is readily determined by those skilled in the art according to standard assays (Biochemistry 1994; 33:47024713 and references cited therein). A variety of these compounds are described and referenced below however other lanosterol demethylase inhibitors will be known to those skilled in the art such as fluconazole and voriconazole. Voriconazole is exemplified in U.S. Pat. No. 5,278,175 (the disclosure of which is hereby incorporated by reference) and is (2R,3S)-2-(2,4-difluorophenyl)-3(5-fluoropyrimidin-4-yl)-1-(1,2,4-triazol-1-yl)butan-2-ol. U.S. Pat. Nos. 4,782,059 and 4,894,375 (the disclosures of which are hereby incorporated by reference) disclose certain azoles such as cis-1-acetyl 4-(4-((2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)1,3-dioxolan-4-yl)methoxy)phenyl) piperazine (ketoconazole). EP publication 492474A (the disclosure of which is hereby incorporated by reference) discloses certain dioxolanes such as (2S,4S)-Cis-2-(2-(4-chlorophenyl)ethyl)-2-imidazol-1-yl)methyl-4-(4-aminophenyl-thio)methyl-1,3-dioxolane. U.S. Pat. No. 5,041,432 (the disclosure of which is hereby incorporated by reference) discloses certain 15-substituted lanosterol derivatives.
The compounds of this invention can be administered individually or together in any conventional oral or parenteral dosage form such as a capsule, tablet, powder, sachet, suspension or solution. For oral administration, which is preferred, a pharmaceutical composition can take the form of solutions, suspensions, tablets, pills, capsules, powders, and the like.
Depending on the intended mode of administration, the pharmaceutical compositions may be in the form of solid, semi-solid or liquid dosage forms, such as, for example, tablets, pills, capsules, powders, liquids, suspensions, or the like, preferably in unit dosage forms suitable for single administration of precise dosages. The pharmaceutical compositions will include a conventional pharmaceutical carrier or excipient and a compound(s) according to the invention as an active ingredient. In addition, it may include other medicinal or pharmaceutical agents, carriers, adjuvants, etc.
Pharmaceutical compositions according to this invention may contain 0.1%-95% of the compound(s) of this invention, preferably 1%-70%. In any event, the composition or formulation to be administered will contain a quantity of a compound(s) according to the invention in an amount effective to treat the condition of the subject being treated, i.e., hypercholesterolemia, atherosclerosis, Alzheimer""s disease or fungal infection.
For solid pharmaceutical compositions, conventional non-toxic solid carriers include, for example, pharmaceutical grades of mannitol, lactose, starch, magnesium stearate, sodium saccharin, talcum, cellulose, glucose, sucrose, magnesium carbonate, and the like.
Liquid pharmaceutically administerable compositions can be prepared by dissolving or dispersing, or otherwise preparing a compound(s) according to this invention and mixing it optionally with a pharmaceutical adjuvant in a carrier, such as, for example, water, saline, aqueous dextrose, glycerol, ethanol, and the like, to thereby form a solution or suspension.
Methods of preparing various pharmaceutical compositions with a certain amount of active ingredient are known, or will be apparent in light of this disclosure, to those skilled in this art. For examples, see Remington""s Pharmaceutical Sciences., Mack Publishing Company, Easter, Pa., 15th Edition (1975).
Since the present invention has an aspect that relates to the treatment of hypercholesterolemia, a fungal infection or acne with a combination of active ingredients which may be administered separately, the invention also relates to combining separate pharmaceutical compositions in kit form. The kit comprises two separate pharmaceutical compositions: a compound of Formula I and a second compound as described above. The kit comprises container means for containing the separate compositions such as a divided bottle or a divided foil packet. Typically the kit comprises directions for the administration of the separate components. The kit form is particularly advantageous when the separate components are preferably administered in different dosage forms (e.g., oral and parenteral), are administered at different dosage intervals, or when titration of the individual components of the combination is desired by the prescribing physician.
An example of such a kit is a so-called blister pack. Blister packs are well known in the packaging industry and are being widely used for the packaging of pharmaceutical unit dosage forms (tablets, capsules, and the like). Blister packs generally consist of a sheet of relatively stiff material covered with a foil of a preferably transparent plastic material. During the packaging process recesses are formed in the plastic foil. The recesses have the size and shape of the tablets or capsules to be packed. Next, the tablets or capsules are placed in the recesses and the sheet of relatively stiff material is sealed against the plastic foil at the face of the foil which is opposite from the direction in which the recesses were formed. As a result, the tablets or capsules are sealed in the recesses between the plastic foil and the sheet. Preferably the strength of the sheet is such that the tablets or capsules can be removed from the blister pack by manually applying pressure on the recesses whereby an opening is formed in the sheet at the place of the recess. The tablet or capsule can then be removed via said opening.
It may be desirable to provide a memory aid on the kit, e.g., in the form of numbers next to the tablets or capsules whereby the numbers correspond with the days of the regimen which the tablets or capsules so specified should be ingested. Another example of such a memory aid is a calendar printed on the card e.g., as follows xe2x80x9cFirst Week, Monday, Tuesday, . . . etc. . . . Second Week, Monday, Tuesday, . . . xe2x80x9d etc. Other variations of memory aids will be readily apparent. A xe2x80x9cdaily dosexe2x80x9d can be a single tablet or capsule or several pills or capsules to be taken on a given day. Also a daily dose of Formula I compound can consist of one tablet or capsule while a daily dose of the second compound can consist of several tablets or capsules and vice versa. The memory aid should reflect this.
In another specific embodiment of the invention a dispenser designed to dispense the daily doses one at a time in the order of their intended use is provided. Preferably, the dispenser is equipped with a memory-aid, so as to further facilitate compliance with the regimen. An example of such a memory-aid is a mechanical counter which indicates the number of daily doses that has been dispensed. Another example of such a memory-aid is a battery-powered micro chip memory coupled with a liquid crystal readout, or audible reminder signal which, for example, reads out the date that the last daily dose has been taken and/or reminds one when the next dose is to be taken.